| NPI | 1740410125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 47920) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2023-05-17 |