| NPI | 1588671291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101027468) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 38155) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-11-02 |