| NPI | 1881799773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD27787) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101233239) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-10-15 |