| NPI | 1760495840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ND 13475) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 22993) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2023-11-02 |