| NPI | 1518101187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS 13121) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2012-00348) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2015-09-25 |