| NPI | 1750611190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 93954) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL OS18219) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 268557) | |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2025-08-07 |