| NPI | 1568582443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301094425) |
| Additional Taxonomies | 282NW0100X General Acute Care Hospital, Women |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-07-21 |