| NPI | 1033503131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NC 2018-02893) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2018-02893) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2022-07-22 |