| NPI | 1386655967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD.014148) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD.014148) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2017-04-19 |