| NPI | 1245573542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 000000) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 82607-20) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2023-09-19 |