NPI | 1811041411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: DC MD33398) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD D0052871) |
207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 201887) | |
Enumeration Date | 2007-01-22 |
Last Update Date | 2007-07-08 |