| NPI | 1679869275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD171926) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 173401) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2015-06-24 |