NPI | 1720158181 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 93818) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO2463) |
207Q00000X Family Medicine (Licence: IN 02003148A) | |
207V00000X Obstetrics & Gynecology (Licence: SC 93818) | |
Enumeration Date | 2006-11-09 |
Last Update Date | 2025-09-16 |