| NPI | 1497296750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101271635) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0116030842) |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2021-06-03 |