| NPI | 1366433419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2023010485) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 4283) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2023-05-08 |