| NPI | 1902885585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 30880) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 030880) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 30880) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2019-09-11 |