| NPI | 1053978742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WI 82298-021) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: SC 89746) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 5151013509) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2026-09-02 |