| NPI | 1093977001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL 126055) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD446256) |
| 207V00000X Obstetrics & Gynecology (Licence: PR 18468) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-03-03 |