| NPI | 1548838832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VT 042.0018639) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2021021439) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2025-09-08 |