| NPI | 1699199232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 10753) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 01028) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-03-25 |