| NPI | 1396719266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9400524) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 56399) |
| 207V00000X Obstetrics & Gynecology (Licence: IA MD-48228) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-03-29 |