| NPI | 1831213438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 26086) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 22670020) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2025-01-09 |