| 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 |