| NPI | 1942596747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: FL ME135626) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Q3871) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2018-07-06 |