| NPI | 1821188426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MI 4301078230) | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: UT 5894905-1205) | 
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2017-03-29 |