| NPI | 1700084548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 82360) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301090889) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2022-01-07 |