| NPI | 1912999236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO179548) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 2808) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-11-03 |