| NPI | 1821095332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9801097) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 81838) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2012-03-02 |