NPI | 1508066457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM A-1560-10) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 0000) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2011-08-19 |