| NPI | 1174549042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 38105) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 038105) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2026-04-10 |