| NPI | 1164495727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 17969) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 015377) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2010-07-26 |