| NPI | 1679589600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 341653-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 341653-1205) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-02-11 |