| NPI | 1306845417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX j6634) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J6634) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2023-07-27 |