| NPI | 1528078748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 30453) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 30453) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-05-11 |