| NPI | 1053392399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101-050317) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: VA 0101050317) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2021-07-20 |