| NPI | 1952303216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WY 8076A) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NM 92-345) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-06-15 |