| NPI | 1710973045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI JI039699) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 58785) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2014-01-28 |