| NPI | 1437158565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 47549) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 30753) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-10-28 |