NPI | 1376895946 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 68445) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 68445) |
Enumeration Date | 2012-10-08 |
Last Update Date | 2023-08-16 |