| NPI | 1780023838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-1026) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2013020281) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2019-01-29 |