| NPI | 1871536896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 026299) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Pending) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: LA 026299) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX Pending) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: LA 026299) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX Pending) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2011-06-22 |