| NPI | 1598763997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CT 015953) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: CT 015953) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2011-10-05 |