| NPI | 1467436006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 1931) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AK 5884) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2011-05-19 |