| NPI | 1225094808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 25429) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM 94212) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2024-04-08 |