| NPI | 1790997443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CO 49767) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 235165) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A93750) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A93750) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2021-06-02 |