| NPI | 1053471094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101033801) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D71659) |
| 207V00000X Obstetrics & Gynecology (Licence: DC MD039161) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-10-11 |