| NPI | 1306934658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 37841) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 032825) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-06-23 |