| NPI | 1932281763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 60476) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 40890) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-03-17 |