| NPI | 1396323580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.44733) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL MD.44733) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-07-15 |