| NPI | 1053384149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 47742) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 47742) |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NC 2011-00362) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2014-11-24 |