| NPI | 1467421230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 212831) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 212831) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-02-07 |