| NPI | 1013477157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0071469) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 30056) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 68011) | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-08-22 |