| NPI | 1508077199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL DO.1290) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34.009142) |
| 207V00000X Obstetrics & Gynecology (Licence: PA Os014474) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-01-30 |