| NPI | 1528008265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9800231) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: NC 9800231) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-02-01 |