| NPI | 1942283163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SD 5985) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: SD 5985) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: SD 5985) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2010-05-14 |