| NPI | 1528157930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 10102) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 24590) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-07-25 |