| NPI | 1861788655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 9349122-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125060096) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-06-25 |