| NPI | 1730368010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 33884) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 033884) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2020-04-15 |