NPI | 1306067384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA MD-47144) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 10905A) |
207V00000X Obstetrics & Gynecology (Licence: OK 25200) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2024-08-09 |