| NPI | 1336157726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2001-00858) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0102201194) |
| 207V00000X Obstetrics & Gynecology (Licence: SD 9930) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-10-25 |