| NPI | 1669566493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 29912) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 36531) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036-091984) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-12-22 |