| NPI | 1225240583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101241300) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0116015002) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-02-06 |