| NPI | 1598846297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 80795) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC LL2-8934) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-06-08 |