| NPI | 1164499026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 39183) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01056423A) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2016-04-11 |