| NPI | 1467481945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 200400186) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101237868) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-08-10 |