| NPI | 1265622732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA PGY.1-LSUNO) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 37540) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2021-01-11 |