| NPI | 1356082572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL 35448) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D0106510) |
| Enumeration Date | 2022-04-03 |
| Last Update Date | 2026-06-22 |