NPI | 1760500193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101255143) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VT 042-0011548) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2020-12-11 |