| NPI | 1457339616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 49268021) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 5101014348) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2021-11-22 |