| NPI | 1477728343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 6825294-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 81074) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2017-03-17 |