| NPI | 1548290141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-10685) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD25272) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2009-06-26 |