| NPI | 1033614011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0102205985) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102205985) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-08-04 |