| NPI | 1851731558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 10368191) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 7092) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2023-10-25 |