| NPI | 1144200916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-0407) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 3140) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-07-19 |