| NPI | 1053350223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 13169) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 31288) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-03-14 |