| NPI | 1912225665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 50660) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 23084) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 52481) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2021-10-01 |