| NPI | 1790851699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 26893) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 0012555) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2024-08-07 |