| NPI | 1356906127 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SD 15578) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0070893) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2025-01-16 |