| NPI | 1003885005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: FL 155340) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036104061) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-08-31 |