| NPI | 1972672517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 28437) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101232836) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-04-19 |