| NPI | 1104860261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AK 6136) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD21361) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-10-12 |