| NPI | 1922082973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 31147) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 41276) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2011-06-23 |