| 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 |