| NPI | 1942425004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: FL OS17080) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101016748) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2022-04-06 |