| NPI | 1669460077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 19812) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL LL726) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2022-07-21 |