| NPI | 1407483720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 011163) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 05316) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-08-21 |