| NPI | 1790737807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 00023921) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 66741) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-01-10 |