| NPI | 1558710111 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV DO2995) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125.069827) | 
| Enumeration Date | 2016-06-05 | 
| Last Update Date | 2023-10-05 |