| NPI | 1316918865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 28350) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 28350) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2024-11-21 |