| NPI | 1780767582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA MD-39150) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 15478) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-03-11 |