| NPI | 1114036027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN 49929) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VT 0420011205) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-06-18 |