| NPI | 1922532472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AK 187278) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101265145) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2022-06-29 |