| NPI | 1295900165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 58018) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 107866) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2026-06-30 |