| NPI | 1689603847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-9485) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID M-9485) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-05-14 |