| NPI | 1154313765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 05-44193) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 01647) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2021-02-20 |