| NPI | 1891704425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 42612) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 6210) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-11-29 |