| NPI | 1992899546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI MM041950) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301041950) |
| 208D00000X General Practice (Licence: MI 4301041950) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-02-22 |