| NPI | 1316358484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 80076) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MTL002503) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2018-04-11 |