| NPI | 1144347568 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NE 24086) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 0431506) | 
| Enumeration Date | 2007-03-22 | 
| Last Update Date | 2015-06-29 |