| NPI | 1124151287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NH 5617) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MA 37039) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-04-15 |