| NPI | 1740282359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME79122) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 35925) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-11-26 |