| NPI | 1508189168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY 45277) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 45277) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301095856) | |
| 207V00000X Obstetrics & Gynecology (Licence: IL 125-051197) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY TP466) | |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2017-08-02 |