| NPI | 1750492393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 29172) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 19210) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-06-28 |