| NPI | 1215937032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: UT 163965-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 163965-1205) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2011-06-27 |