| NPI | 1033159389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL 13475) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL 00137475) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-01-05 |