| NPI | 1780812594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME116310) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301093891) |
| 207V00000X Obstetrics & Gynecology (Licence: FL 116310) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-09-09 |