| NPI | 1124065412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MA 60014) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 60014) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2009-08-31 |