| NPI | 1093734360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 65832) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 61253491205) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-13 |