| NPI | 1427484237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY KY17193) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 6152) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |