| NPI | 1306042619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: MO 2018009510) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: TN 51003) |
| 207V00000X Obstetrics & Gynecology (Licence: OK 25614) | |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2018-07-10 |