| NPI | 1760470801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 18703)  | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: CO 18703)  | 
| Enumeration Date | 2005-10-12 | 
| Last Update Date | 2012-09-17 |