| NPI | 1467865006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 25618) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101020917) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2018-08-02 |