| NPI | 1942884325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2025-02173) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 85938) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-10-24 |