| NPI | 1760422075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 7912) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 00007912) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2009-01-02 |