| NPI | 1063408409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E7806) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 9601) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-12-02 |