| NPI | 1023055977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2009-00338) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 13228) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2009-08-13 |