| NPI | 1912925223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 34018) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ND 22993) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-03-11 |