| NPI | 1376550731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 51000) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD195837) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: WA MD6099378) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-05 |