| NPI | 1013910157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AZ 53209) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 13613) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2021-09-13 |