| NPI | 1124128111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101042387) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D69405) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-10-27 |