| NPI | 1922092915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 27209) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 18030) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2013-09-25 |