| NPI | 1790722296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301024731) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MI 4301024731) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2017-04-28 |