| NPI | 1134119720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301045262) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI FR045262) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2021-02-23 |