| NPI | 1164485470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DE C1-0010768) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010008638) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 158011) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2020-10-06 |