| NPI | 1396795407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 29133) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ND 4645) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-12-10 |