| NPI | 1063445922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 32881) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ND 14344) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-12-21 |