| NPI | 1982892774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 99041338A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036120164) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2020-09-10 |