NPI | 1205129905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: CT 1.054756) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 54756) |
Enumeration Date | 2011-05-27 |
Last Update Date | 2020-11-22 |