| NPI | 1962464396 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY TP858)  | 
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OR MD26237)  | 
| Enumeration Date | 2006-04-03 | 
| Last Update Date | 2016-03-17 |