| NPI | 1629156955 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DC MD034494) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D0056536) | 
| Enumeration Date | 2006-11-02 | 
| Last Update Date | 2012-10-29 |