| NPI | 1336463108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-1563) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR DO166693) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2022-06-13 |