| NPI | 1487608451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 24514) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 030173) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2016-05-06 |