| NPI | 1275160384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2023041281) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5151014316) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-05-09 |