| NPI | 1689858532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2005-01740) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 44993) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2023-08-11 |