| NPI | 1184617862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 69640-20) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME75697) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2018-10-01 |