| NPI | 1831396449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-13979) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301090532) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2021-02-24 |