| NPI | 1912016742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: GA 90992) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101055788) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-06-05 |