| NPI | 1487234936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 86008) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC LL86008) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2025-08-06 |