| NPI | 1629189139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 27364) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 18305) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |