| NPI | 1881856102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 94237) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2011-01122) |
| 207V00000X Obstetrics & Gynecology (Licence: SC 82899) | |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101246130) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2024-11-04 |