| NPI | 1154499978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 46638) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 46638) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-07-09 |