| NPI | 1669471538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 28714) |
| Additional Taxonomies | 173000000X Legal Medicine |
| 174400000X Specialist (Licence: OK 17891) | |
| 174400000X Specialist (Licence: CO 28714) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2025-06-02 |