| NPI | 1316907736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 29319) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: HI 10716) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2022-01-04 |