| NPI | 1831892884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 77653) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 33363) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2024-08-14 |