| NPI | 1205878113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E2520) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA MD.200550) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-11-29 |