| NPI | 1982024436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: FL 163508) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A158571) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-07-17 |