| NPI | 1245280908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 17694) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 39891) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2018-04-11 |