| NPI | 1417902164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS4624) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD H0063736) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-03-24 |