| NPI | 1508981663 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MT 11793) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 97-00636) |
| 207V00000X Obstetrics & Gynecology (Licence: MT 11793) | |
| 207V00000X Obstetrics & Gynecology (Licence: CO 46424) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-04-20 |