| NPI | 1174593941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 48266) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 102171) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2024-01-02 |