| NPI | 1841360039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 012372) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 012372) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |