| NPI | 1255300893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: KS 04-14447) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MO R5071) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2015-09-15 |