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 |