| NPI | 1558526681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD175576) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301092880) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2017-05-25 |