| NPI | 1487717864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 202143) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL TRN7866) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-11-22 |