| NPI | 1750402269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301091473) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA AOH300) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2019-04-25 |