| NPI | 1801896295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX E0847) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX E0847) | 
| 207V00000X Obstetrics & Gynecology (Licence: TX E0847) | |
| Enumeration Date | 2005-07-28 | 
| Last Update Date | 2024-01-19 |