| NPI | 1093979429 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SD 8503) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 5918) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2022-04-29 |