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 |