| NPI | 1720728934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 83856) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC LL83856) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2026-09-08 |