| NPI | 1821045253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 21210) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 21210) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2025-08-21 |