| NPI | 1912010950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NE 12833) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 22384) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2015-06-30 |