| NPI | 1437119781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 52561) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 45450) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-11-17 |