| NPI | 1932105301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NM MD2015-0518) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO 110913) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-07-01 |