| NPI | 1033408968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2018015705) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2015-02277) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2025-02-13 |