| NPI | 1376517789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME128170) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01053765A) |
| 207V00000X Obstetrics & Gynecology (Licence: GA 65312) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-02-07 |