| NPI | 1760422984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA 016883E) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA 016883E) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-01-23 |