| NPI | 1083601199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 69678) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 37015) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2025-11-03 |