| NPI | 1093707432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101265277) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9701017) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2021-08-12 |