| NPI | 1053831818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 93958) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101023115) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2025-02-10 |