| NPI | 1245231943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E3187) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 3043) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2011-11-08 |