| NPI | 1548469208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 54222) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: ND 11956) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2022-04-29 |