| NPI | 1508056490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: FL ME112420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL TRN8783) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2019-06-20 |