| NPI | 1194772855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 22361-020) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 62043) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2021-03-11 |