| NPI | 1477816890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME159490) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301101301) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MI 4301101301) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-12-22 |