| NPI | 1477713543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 31304) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY TP535) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-04-26 |