| NPI | 1114913514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 038629) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 1128) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-07-28 |