| NPI | 1225134406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 04-26869) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO R4F52) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2018-02-27 |