| NPI | 1801319033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OH 57.251673) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10060904) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2021-06-18 |