| NPI | 1457338774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 41872) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 41872) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-08-13 |