| NPI | 1689692410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 50634) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036-119964) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-10-20 |