| NPI | 1639201635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR MD13588) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD13588) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-03-04 |