| NPI | 1285606442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113678) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036112905) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-02-01 |