| 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 |