| NPI | 1184839854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2013-0700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 22538) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2015-08-10 |