| NPI | 1053844027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 61629) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME MD21221) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2021-07-26 |