| NPI | 1811331663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-14718) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301103276) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 2154193) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2022-07-21 |