| NPI | 1902828635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: LA 020778) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 020778) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2014-07-14 |