NPI | 1962852251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS16659) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OT017172) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2020-08-03 |