| NPI | 1124399423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 67840) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 67840) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 67840) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: GA 67840) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2019-10-30 |