| NPI | 1356422281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: DC MD2904) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101018199) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD D0009376) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2011-12-29 |