| NPI | 1134323843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD28519) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD28519) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-06-15 |