| NPI | 1255717039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OK 40925) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CO DR.0063127) |
| 207V00000X Obstetrics & Gynecology (Licence: CO DR.0063127) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2023-07-10 |