| NPI | 1407847700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MA 75925) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 75925) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2012-11-16 |