| NPI | 1891925616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21277) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MS 21277) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2011-02-09 |