| NPI | 1164408688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: AL 27286) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 45645) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2025-05-06 |