| NPI | 1942276878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 11336) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL D0808) |
| 207V00000X Obstetrics & Gynecology (Licence: LA 07708R) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2015-04-14 |