| NPI | 1932362985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101257200) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 8029A) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2020-11-06 |