| NPI | 1740474311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D0071665) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301091018) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2021-12-09 |