| NPI | 1114902590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA MD-42240) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME62537) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2015-02-04 |