| NPI | 1083908644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2015-01007) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 2015-01007) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NC 2015-01007) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2015-06-29 |