| NPI | 1629175302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 28887) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM MD2016-0286) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2025-04-02 |