| NPI | 1033111703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 10986) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 10986) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-12-21 |