| NPI | 1609974385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 062302) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 9535A) |
| 207V00000X Obstetrics & Gynecology (Licence: MT 26750) | |
| 207V00000X Obstetrics & Gynecology (Licence: SD 8895) | |
| 207V00000X Obstetrics & Gynecology (Licence: MI 5101016269) | |
| 207V00000X Obstetrics & Gynecology (Licence: ND 9887) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-10-06 |