| NPI | 1386647550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: TN 9356) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL 98837) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-04-16 |