| NPI | 1245430024 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301090134) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MI 4301090134) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2023-08-25 |