| NPI | 1972917581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 37125) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC LL37125) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-06-09 |