| NPI | 1508420340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101285343) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D97146) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2025-06-06 |