| NPI | 1982641189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MS 12843) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL 00016908) |
| 208800000X Urology (Licence: MS 12843) | |
| 208800000X Urology (Licence: AL 00016908) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2012-02-08 |