| NPI | 1366475568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: KY 38316) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 38316) |
| 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: KY 38316) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2025-01-07 |