| NPI | 1063458149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5101007780) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101007780) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-05-14 |