| NPI | 1194755793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 30290) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 04-28958) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-09-09 |