| NPI | 1245486091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 81712) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MT 12681) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2023-10-30 |