| NPI | 1013987908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101049499) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 31705) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2013-09-23 |