| NPI | 1801997267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 86997) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 156629) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-02-07 |