| NPI | 1396731790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 20666) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 048817) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301050507) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2024-02-13 |