| NPI | 1992854905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101023302) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD5187) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2016-01-19 |