| NPI | 1326012964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DE C10008961) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2001030315) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2011-02-11 |