| NPI | 1891011359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 1525) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 256077) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2013-11-05 |