NPI | 1548780653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 83745) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2017018654) |
Enumeration Date | 2017-06-21 |
Last Update Date | 2025-07-09 |