| NPI | 1013957927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MI RC036412) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301036412) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-07-17 |