| NPI | 1215098454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 020111) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL 026123) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-06-15 |