| NPI | 1922154376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 14587) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: PR 14587) |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: PR 14587) | |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: PR 14587) | |
| 261QA0005X Clinic/Center Ambulatory Family Planning Facility (Licence: PR 14587) | |
| 261QA1903X Clinic/Center Ambulatory Surgical (Licence: PR 14587) | |
| 261QF0050X Clinic/Center Family Planning, Non-Surgical (Licence: PR 14587) | |
| 261QP0905X Clinic/Center Public Health, State or Local (Licence: PR 14587) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2013-10-29 |