| NPI | 1467647776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G88898) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD D0072935) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: DC MD039630) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2014-09-17 |