| NPI | 1114244514 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: ID M-17863)  | 
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NM MD2014-0229)  | 
| Enumeration Date | 2010-04-23 | 
| Last Update Date | 2024-08-01 |