| NPI | 1255453130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E5854) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AR E-5854) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2014-10-13 |