| NPI | 1437299724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY TP969) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD213166) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 430166276) | |
| 207V00000X Obstetrics & Gynecology (Licence: WI 100764-875) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2024-05-29 |