| NPI | 1679563852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 19496) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 047311) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2021-05-13 |