| NPI | 1386026144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 83039) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 7584) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-10-17 |