| NPI | 1205892536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 34096) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 22985) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2014-03-07 |