| NPI | 1285641753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 16409) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 160409) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-10-27 |