| NPI | 1588648638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 50133) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036-110700) |
| 207V00000X Obstetrics & Gynecology (Licence: WI 50387) | |
| 207V00000X Obstetrics & Gynecology (Licence: TN 50133) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2021-02-27 |