| NPI | 1548246440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NV 5775) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NV 5775) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-03-08 |