| NPI | 1548375637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2017031964) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM MD2003-0686) |
| 207V00000X Obstetrics & Gynecology (Licence: CO 44508) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-02-26 |