| NPI | 1295828978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 056706) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301078310) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-03-15 |