| NPI | 1730154071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX E4310) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E4310) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-03-21 |