| NPI | 1164652343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2013-00141) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125056036) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2015-12-07 |