| NPI | 1144410127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 63516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 241913) |
| 207Q00000X Family Medicine (Licence: CT 047603) | |
| 207Q00000X Family Medicine (Licence: NV 14053) | |
| 207V00000X Obstetrics & Gynecology (Licence: NV 14053) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2021-07-09 |