| NPI | 1508150731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS19930) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 981) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-04-25 |