| NPI | 1174605869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DC 13143) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D21093) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |