| NPI | 1578583092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 79134) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GU M-1736) |
| 207V00000X Obstetrics & Gynecology (Licence: CA A94599) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-02-08 |