| NPI | 1528320660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MO 33078) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 33078) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |