| NPI | 1215181656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101253590) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY R1934) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 44975) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2013-05-16 |