| NPI | 1225063647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 3863) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 05-46905) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-11-02 |