| NPI | 1376528430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 16919) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: NC 16919) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-07-08 |