| NPI | 1902815939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD.026003) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 026003) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2014-06-09 |