| NPI | 1396849998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 9501030) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 040176) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2008-08-26 |