| NPI | 1871591115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY C4882) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036084462) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 1020631) | |
| 207V00000X Obstetrics & Gynecology (Licence: CO DR.0067812) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2026-04-28 |