| NPI | 1487618658 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 30960) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 33983) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2015-05-04 |