| NPI | 1184794349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM A-2192-18) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 3715) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-10-19 |