| NPI | 1598701948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 23976) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 27213) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-12-09 |