| NPI | 1801980289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM 99-214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 99-214) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-06-02 |