| NPI | 1659310191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 63368) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MT 20182) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-02-07 |