| NPI | 1972611655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G051761) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D0047027) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 1545281) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-11-21 |