| NPI | 1225051808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 09992R) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 12488) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-02-02 |