| NPI | 1184796070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: VA 0101043063) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101043063) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2021-09-13 |