| NPI | 1932188166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 29974) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 31510) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2015-08-18 |