| NPI | 1831198134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 36769) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 020494) | 
| 208M00000X Hospitalist (Licence: NC 36769) | |
| Enumeration Date | 2005-07-19 | 
| Last Update Date | 2024-04-24 |