| NPI | 1578580536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: AR E7297) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2006-00926) |
| 208600000X Surgery (Licence: LA MD025689) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-09-11 |