| NPI | 1902944408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 110075) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036047422) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036047422) | |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01063370A) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-05-11 |