| NPI | 1225016132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 13808) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PR 20576) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2016-09-27 |