| NPI | 1952303919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MT 74443) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI RP407341) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD463673) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2023-11-09 |