| NPI | 1932183050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 42468) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 41236) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2024-02-28 |