| NPI | 1699798504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 29173) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2010-01153) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-01-05 |