| NPI | 1922203371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 062794) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 60850-21) |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2022-06-08 |