| NPI | 1336331958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 328232-1204) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ R946) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2010-08-04 |