| NPI | 1740273010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301073494) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD428982) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2023-04-05 |