| NPI | 1396843538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO199989) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 5101012996) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-09-28 |