| NPI | 1184821985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ND 12018) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301090699) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2019-02-26 |