| NPI | 1821098393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: LA md07659r) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: LA 07659R) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2013-03-05 |