| NPI | 1023370640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 5476) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2017033229) |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2024-08-21 |