NPI | 1538333794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY TP743) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 81706) |
Enumeration Date | 2008-04-18 |
Last Update Date | 2011-06-10 |