| NPI | 1053841213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2021-0515) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2017023787) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2023-11-14 |