| NPI | 1265962039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD482820) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0065747) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-10-09 |