| NPI | 1649629015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NV 23420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125.068704) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2026-05-21 |