NPI | 1275084477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 100074) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 04-31961) |
Enumeration Date | 2016-10-23 |
Last Update Date | 2016-10-23 |