| NPI | 1407351836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2022010875) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY R4876) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2022-06-03 |