| NPI | 1538165352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 021164) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 021164) |
| 207V00000X Obstetrics & Gynecology (Licence: GA 021164) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2010-12-10 |