| NPI | 1831191527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX G5044) |
| Additional Taxonomies | 174400000X Specialist (Licence: AK 4644) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2022-10-03 |