| NPI | 1063527547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 46573-20) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 46573) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 57207) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2026-07-15 |