| NPI | 1174534150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CT 026709) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: CT 026709) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CT 026709) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |