| NPI | 1194985036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PR 17817) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 06169) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2010-11-12 |