| NPI | 1881888550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 30270) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC TL30270) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2016-07-18 |