| NPI | 1780207878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2024-02636) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 93061) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2024-09-17 |