| NPI | 1700222775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OH 35.135273) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 60570-20) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD447422) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2022-10-18 |