| NPI | 1972614956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-17901) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ AZ21398) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-08-29 |