| NPI | 1386602449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SD 4164) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MT 91102) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-11-30 |