| NPI | 1508833120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A93277) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 41895) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2021-12-15 |