| NPI | 1477757052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: GA 87091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 264972) |
| 207V00000X Obstetrics & Gynecology (Licence: TX BP1-0026607) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-08-25 |