| NPI | 1316986714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 158955-1205) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: UT 1589551205) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2012-09-17 |