| NPI | 1659303469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 38734) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 16079) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-09-27 |