| NPI | 1215292339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NM MD2016-0236) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301100755) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2023-07-12 |