| NPI | 1952452310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 92992) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 13880) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2022-08-05 |