| NPI | 1497798854 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208VP0000X (Licence: GA 041733) | 
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: GA 041733) | 
| Enumeration Date | 2006-06-14 | 
| Last Update Date | 2022-10-28 |