| NPI | 1548383532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101058140) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101058140) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |