| NPI | 1487238853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5151014831) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 012102) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-12-23 |