| NPI | 1295936722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2009-1673) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 91390) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-07-17 |