| NPI | 1881918100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 6457-851) |
| Additional Taxonomies | 208600000X Surgery (Licence: ZZ 5404382) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2016-12-26 |