| NPI | 1093911802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101246646) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 40839) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2011-05-04 |