| NPI | 1942257589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 40628) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 13983) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2007-07-09 |