| NPI | 1235304171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 37240) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: AZ 37240) |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 81650) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-03-23 |