| NPI | 1063519445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: WV 22945) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 13100) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-12-14 |