| NPI | 1609060698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0102202257) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 39020000X) |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2021-10-26 |