| NPI | 1154413805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL OS4039) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS 4039) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-01-30 |