| NPI | 1598792525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101240033) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101240033) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-02-20 |