| NPI | 1497771034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 053032) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 53032) |
| 208000000X Pediatrics (Licence: GA 53032) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2012-12-05 |