| NPI | 1063436988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV DO2032) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 13955169-1234) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036076712) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2026-05-20 |