| NPI | 1770015703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: OH 35.150853) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: KY 59298) |
| 207V00000X Obstetrics & Gynecology (Licence: TX T7572) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2024-08-15 |