| NPI | 1801909718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SD 4683) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA MD52141) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2023-12-19 |