| NPI | 1861913048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX 48795) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301504583) |
| 207V00000X Obstetrics & Gynecology (Licence: TX 48795) | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MI 4301504583) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2025-08-12 |