| NPI | 1790943132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-12580) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2013026058) |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2016-02-16 |