| NPI | 1215909049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MT 7546) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ND 9220) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-02-23 |