| NPI | 1265926612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2018017094) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KS 94-10855) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-09-15 |