| NPI | 1831198134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 36769) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 36769) |
| 207V00000X Obstetrics & Gynecology (Licence: LA 020494) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2023-03-10 |