| NPI | 1598250334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-1963) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5151014177) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2024-07-02 |