| NPI | 1538423561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MO 2016009496) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2016009496) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2025-01-10 |