NPI | 1669489100 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2020-02536) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 1032) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2023-06-13 |