| NPI | 1063400240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 35610) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: SC 35610) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2017-01-27 |