| NPI | 1720078520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD206213) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD436149) |
| 207V00000X Obstetrics & Gynecology (Licence: GA 055817) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2017-07-18 |