| NPI | 1629177753 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A17697) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036106905) | 
| 207V00000X Obstetrics & Gynecology (Licence: NY 249719) | |
| Enumeration Date | 2006-09-22 | 
| Last Update Date | 2021-03-08 |