| NPI | 1437146065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR CP209732) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 49187661205) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2022-04-18 |