| NPI | 1649201369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 04-30558) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 30558) |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 44323) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-05-08 |