| NPI | 1144392903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV N4826) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 236974) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-03-04 |