| NPI | 1710103619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 064060) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PA MD130914) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2010-11-11 |