| NPI | 1114072931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 60666) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 4301054854) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-12-28 |