| NPI | 1194828715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 23568) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 13865) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-01-15 |