| NPI | 1962446401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 28740) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CO 28470) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2016-08-31 |