| NPI | 1104899624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101248418) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D0061988) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2021-10-29 |