| NPI | 1164491270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AR C-4534) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OK 26911) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-10-15 |