| NPI | 1578990206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 32659) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 272031) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2022-03-08 |