| NPI | 1558413807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MS 11279) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN 15990) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-02-15 |