| NPI | 1154589505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD177831) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA R-8345) |
| Enumeration Date | 2008-06-01 |
| Last Update Date | 2022-01-28 |