| NPI | 1770515868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 11768) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 15444) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 24486) | |
| 207V00000X Obstetrics & Gynecology (Licence: FL 44986) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-02-22 |