| NPI | 1215315353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR0067383) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 58551) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2023-03-14 |