| NPI | 1356364541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 101052) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 101052) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-12-14 |