| NPI | 1811551153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301509110) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4351044098) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2025-05-20 |