| NPI | 1295728202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5101007155) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI MA007155) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2022-07-15 |