| NPI | 1942220520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WY 16657A) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD215827) |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD61210648) | |
| 207V00000X Obstetrics & Gynecology (Licence: ME MD16966) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-05-29 |