| NPI | 1427037795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2008-00847) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 038176) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2016-08-11 |