| NPI | 1891773578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101046176) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: VA 0101046176) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2012-09-13 |