| NPI | 1982881199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 43290) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 74023) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2016-03-17 |