| NPI | 1346580842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34.014376) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA OP60746570) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 5101020304) | |
| 207V00000X Obstetrics & Gynecology (Licence: ID O-1792) | |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2023-06-01 |