| 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 |