| NPI | 1881819183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 54873-020) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301086033) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2024-04-05 |