| NPI | 1700804242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: AL 15177) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: AL 15177) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-10-10 |