| NPI | 1962602755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2010-00224) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NC 2010-00224) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: NC 2010-00224) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-06-14 |