| NPI | 1700879699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NC 28261) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NC 28261) |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NC 28261) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2024-12-05 |