| NPI | 1265498331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 39641) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 20046) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-09-17 |