| NPI | 1336404466 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 59878)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301101541)  | 
| 207V00000X Obstetrics & Gynecology (Licence: PA MD466017)  | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MI 4301101541)  | |
| Enumeration Date | 2012-07-04 | 
| Last Update Date | 2025-02-13 |