| NPI | 1679598759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: HI 17220) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 36895) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-03-12 |