| NPI | 1255325718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 37989) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01050576A) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2015-10-26 |