| NPI | 1851342349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301078174) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VT 042.0012157) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2022-09-13 |