| NPI | 1669491031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NV DO3051) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 5583587-1204) |
| 207V00000X Obstetrics & Gynecology (Licence: NV PENDING) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-03-11 |