NPI | 1104830249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 327575) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME70820) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2021-11-02 |