| NPI | 1710963707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MN 45694) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2006-00228) |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NC 2006-00228) | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MD D68363) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2017-10-04 |