| NPI | 1861813651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 19641) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 29490R) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2017-08-21 |