| NPI | 1629055074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO R9556) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: MO R9556) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2007-07-08 |