| NPI | 1174017909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VT 032-0133994) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OT018640) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-07-03 |