| NPI | 1568438117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 16711) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 00025157) |
| 207V00000X Obstetrics & Gynecology (Licence: LA MD.023063) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2015-04-14 |