| NPI | 1699979252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX TP1-0024578) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME146339) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2022-03-16 |