| NPI | 1417213596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: FL OS16190) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: PA OS018252) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2019-11-18 |