| NPI | 1255631313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 14978) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SD 7880) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME104637) | |
| Enumeration Date | 2010-10-23 |
| Last Update Date | 2021-12-15 |