| NPI | 1962848044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1019635) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301113556) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-07-03 |