| NPI | 1508074857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101243711) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT185008) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2025-01-16 |