NPI | 1669677837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A108351) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 250973) |
Enumeration Date | 2007-06-18 |
Last Update Date | 2024-10-03 |