NPI | 1326547704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 60058) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2022-01849) |
Enumeration Date | 2018-02-12 |
Last Update Date | 2025-06-09 |