| NPI | 1063447043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD28585) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM 98132) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-10-02 |