| NPI | 1619954500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 31474) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 31474) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-07-15 |