| NPI | 1841527504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS12755) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2023-03313) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2024-03-12 |