| NPI | 1730318148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME143561) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036124772) |
| 207V00000X Obstetrics & Gynecology (Licence: TX N5518) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2020-10-20 |