NPI | 1205055027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: FL ME96115) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME96115) |
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 243815) | |
Enumeration Date | 2007-04-24 |
Last Update Date | 2020-10-26 |