| NPI | 1487734752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 19664) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 34974) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-07-26 |