| NPI | 1811065725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 30001) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101245336) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2011-08-12 |