| NPI | 1235168642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2013-0799) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101045353) |
| 207V00000X Obstetrics & Gynecology (Licence: WV 24636) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-12-03 |