| NPI | 1962459222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 043738) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 043738) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-04-18 |