| NPI | 1518977917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 969) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101013181) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-02-26 |