| NPI | 1700947256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: DC 11875) | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: DC 11875) | 
| Enumeration Date | 2006-12-12 | 
| Last Update Date | 2007-07-10 |