| NPI | 1740639327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 85507) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 90811) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2024-07-23 |