| NPI | 1184608010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD.15026R) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 15026R) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-03-07 |