| NPI | 1215904644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 14747) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 00017471) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2019-01-24 |