| NPI | 1205844420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OK 15169) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 15169) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2022-06-14 |