| NPI | 1801200985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 13442637-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME139815) |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01087486A) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-07-13 |