| NPI | 1700844248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-01060) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ID M-9293) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-11-15 |