| NPI | 1245385962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00047723) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 44235) |
| 207V00000X Obstetrics & Gynecology (Licence: TN 63060) | |
| 207V00000X Obstetrics & Gynecology (Licence: OR MD214999) | |
| 207V00000X Obstetrics & Gynecology (Licence: UT 373956-1205) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-10-09 |