| NPI | 1932558129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD203114) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MT 88379) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2021-03-12 |