| NPI | 1801839485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 20614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 20614) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2023-12-13 |