| NPI | 1295938751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0116017019) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 22762) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101242511) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2023-06-20 |