| NPI | 1316127889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 17809) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 5722) |
| 207V00000X Obstetrics & Gynecology (Licence: WY 9602A) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2018-07-09 |