| NPI | 1114906252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 511807-1204) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 5111807-1204) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2022-10-13 |