| NPI | 1063656916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 04-13176) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO R7187) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2009-04-22 |