| NPI | 1922675693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 78992) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125.077905) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2025-07-11 |