| NPI | 1790779866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: IA 29026) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 29026) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2007-12-04 |