| NPI | 1659378479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AZ 33356) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NE 13067) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-06-11 |