| NPI | 1578621900 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OR MD15830) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD15830) | 
| Enumeration Date | 2006-12-05 | 
| Last Update Date | 2021-04-21 |