| NPI | 1902867658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: FL ME99842) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: MI 4301046714) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-05-12 |