| NPI | 1588734081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301041053) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 4301041053) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-04-13 |