| NPI | 1851351308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 39990) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 12613A) |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01080582A) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-02-04 |