| NPI | 1114992526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9601420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 18906) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2019-06-14 |