| NPI | 1093745978 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: LA 307178)  | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MS 21655)  | 
| Enumeration Date | 2006-07-04 | 
| Last Update Date | 2025-09-12 |