| NPI | 1902329295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME172710) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 62826) |
| 207V00000X Obstetrics & Gynecology (Licence: CO CDR.0006318) | |
| 207V00000X Obstetrics & Gynecology (Licence: KS 0452134) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2026-03-03 |