| NPI | 1134380470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 12832) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 61736) |
| 207V00000X Obstetrics & Gynecology (Licence: WI 65197) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-04-22 |