| NPI | 1548337975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD482927) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D71153) |
| 207V00000X Obstetrics & Gynecology (Licence: AK 3268) | |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101247965) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-03-13 |