| NPI | 1689247827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2025023718) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2021022120) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2025-08-14 |