| NPI | 1194708081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR 173545) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 23610) |
| 207V00000X Obstetrics & Gynecology (Licence: HI 13367) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2021-07-06 |