| NPI | 1134229891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 15683) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 15683) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2009-11-30 |