| NPI | 1124001862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO20644) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: ID O-186) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR DO20644) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2025-09-23 |