| NPI | 1154381861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 014906) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 14906) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2015-05-07 |