| NPI | 1205814258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: KY R2532) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9601722) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2024-03-04 |