| NPI | 1245341114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD22301) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00038287) |
| 207V00000X Obstetrics & Gynecology (Licence: TX K8960) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-02-04 |