| NPI | 1235387218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 8191663-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ R70627) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2022-02-01 |