| NPI | 1184615304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR MD24939) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD24939) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2026-01-28 |