| NPI | 1518080647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0102202018) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0102202018) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2021-08-04 |