| NPI | 1861855926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101275889) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD047991) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-10-20 |