| NPI | 1932371085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NE 28226) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 54131-20) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2015-06-04 |