| NPI | 1518987163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD018939) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 108939) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-05-13 |