| NPI | 1710419833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 47632) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2018-02603) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-12-01 |