| NPI | 1407845324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101274934) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY TP582) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 44232) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2024-02-27 |