| NPI | 1336119304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2014010396) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 12281) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2024-02-13 |