| NPI | 1932189719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101244420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2007-00872) |
| 207V00000X Obstetrics & Gynecology (Licence: AR E10222) | |
| 207V00000X Obstetrics & Gynecology (Licence: SC 36082TL) | |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35066004) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-10-25 |