| NPI | 1700842564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: LA md05226r) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: LA md05226r) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2008-01-17 |