| NPI | 1689667735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J5655) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J5655) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2014-02-20 |