| NPI | 1114140605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301081975) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 4301081975) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2014-12-30 |