| NPI | 1003850900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D0070822) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DE C10007365) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-01-05 |