| NPI | 1548262306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E0733) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 3067) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2011-11-08 |