| NPI | 1932335890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 51259) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 51082) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2022-08-15 |