| NPI | 1831398411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 32295) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 024879) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2023-03-07 |