| NPI | 1902829856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 09877R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 09877R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-11-04 |