| NPI | 1528040375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 18131) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 11401) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-11-09 |