| NPI | 1902980394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 30540) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 37853) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-01-25 |