| NPI | 1811919731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX N2576) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036088946) |
| 207V00000X Obstetrics & Gynecology (Licence: CA G88426) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-10-06 |