| NPI | 1972507911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61537370) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MI JL064022) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI JL064022) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2024-03-21 |