| NPI | 1194773002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 024731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 024731) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-07-21 |