| NPI | 1396892824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DC MD25834) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101025358) |
| 207V00000X Obstetrics & Gynecology (Licence: MD D0019021) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |