| NPI | 1205866597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301514905) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD417222) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-09-17 |