| NPI | 1639181712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J2287) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME MD29147) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-02-11 |