| NPI | 1922084508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2009-00271) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101233987) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-10-25 |