| NPI | 1245206895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MS 07499) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: LA 03499R) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-06-09 |