| NPI | 1245205202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA DO-04604) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 54969-021) |
| 207V00000X Obstetrics & Gynecology (Licence: NE 428) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2019-06-28 |