| NPI | 1083175251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 31747) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 41927) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-08-18 |