| NPI | 1407837982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 73032) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2002024249) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2024-06-21 |