| NPI | 1053724757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301105829) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME MD22161) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-05-15 |