| NPI | 1578638102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD011668) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2001021523) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2011-02-07 |