| NPI | 1942799804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301518405) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036175917) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2022-01254) | |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2026-08-18 |