| NPI | 1780973305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D80259) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101258139) |
| 207V00000X Obstetrics & Gynecology (Licence: OK 28572) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2018-06-11 |