| NPI | 1245646157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WI 76199) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 76199) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 125066026) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2024-06-27 |