| NPI | 1487625505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3684) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OK 3684) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2017-04-05 |