| NPI | 1689664336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2013-01534) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101034676) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2024-03-01 |