| NPI | 1245290535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E0962) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2025040477) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2025-10-17 |