| NPI | 1174507214 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KS 04-25791) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MO 111304) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2024-10-02 |