| NPI | 1417952102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 13467R MD) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 13467R) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-03-07 |