| NPI | 1851373005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 005715) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101010720) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-10-07 |