| NPI | 1124099940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AZ 21079) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 21070) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-09-13 |