| NPI | 1942430103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2013043016) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301094802) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2017-12-04 |