| NPI | 1538143276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 22953) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD19312) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2012-06-15 |