| NPI | 1790757177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD6152463) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036096280) |
| 207Q00000X Family Medicine (Licence: WA MD6152463) | |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036096280) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-08-14 |