| NPI | 1538270624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R3J87) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MO R3J87) |
| 207V00000X Obstetrics & Gynecology (Licence: MO R3J87) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO R3J87) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-02-24 |