| NPI | 1225024623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 8713) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 8713) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2017-07-18 |