| NPI | 1265512073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 5795) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 5795) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2023-06-26 |