| NPI | 1114404233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NE 8271) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 6681739-1205) |
| Enumeration Date | 2018-07-21 |
| Last Update Date | 2026-03-26 |