| NPI | 1780145813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: UT 14206976-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2023-02712) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-07-01 |