NPI | 1366753089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-13098) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010017738) |
207V00000X Obstetrics & Gynecology (Licence: WA MD60444120) | |
Enumeration Date | 2010-06-28 |
Last Update Date | 2016-06-28 |