| NPI | 1922504042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NV 22558) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NV NVPending) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-07-21 |