| NPI | 1841292216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2000157966) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101013236) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2021-02-24 |