| NPI | 1831785591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: CT 67160) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CT 67160) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: CT 67160) | |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |