NPI | 1699923128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: VA 0101246833) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: AL 32393) |
Enumeration Date | 2008-09-09 |
Last Update Date | 2024-04-15 |