| NPI | 1699826255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A108104) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD P20107) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2015-06-02 |