| NPI | 1386671683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101261470) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MD D0069726) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-07-07 |