| NPI | 1902398597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301508518) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301114980) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-03-10 |