NPI | 1639499783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 5488876-1205) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010017742) |
Enumeration Date | 2010-06-10 |
Last Update Date | 2023-06-28 |