| NPI | 1811167216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301104199) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01064891) |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD60066926) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2014-01-29 |