| NPI | 1750543955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 11060885-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 70819) |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2024-04-17 |