| NPI | 1518952563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WI 45404) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 45404) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2012-02-01 |