| NPI | 1982644282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD167094) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301053932) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-10-22 |