| NPI | 1144230343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301062524) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM MD2012-0088) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-09-10 |