| NPI | 1699790071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 060793) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 02655) |
| 207V00000X Obstetrics & Gynecology (Licence: GA 060793) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-08-18 |