| NPI | 1407880081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO R7908)  | 
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO R7908)  | 
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MO R7908)  | |
| Enumeration Date | 2006-07-10 | 
| Last Update Date | 2009-12-28 |