| NPI | 1831518554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM DO2022-0016) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS020659) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2023-02-22 |