| NPI | 1558598771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 305351) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2014008994) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-07-21 |