| NPI | 1386732048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 028394) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 00012125) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 26626) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-03-23 |