| NPI | 1538165238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM 2000254) |
| Additional Taxonomies | 176B00000X Midwife (Licence: NM R33612) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2021-05-03 |