| NPI | 1336239284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 34321) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301078519) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-07-02 |