| NPI | 1083105944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: GA 110669) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101268060) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2026-05-21 |