| NPI | 1891766804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 17443) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SD 4538) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2023-03-07 |