| NPI | 1144259011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101055569) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: VA 0101055569) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-03-31 |