| 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 |