| NPI | 1942209424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301060216) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI JL060216) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-05-28 |