| NPI | 1649388802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WI 31319) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: WI 31319) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2014-06-13 |