| NPI | 1396763793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-5040) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID M5040) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-12-10 |