| NPI | 1760462618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 3112) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2005036202) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-01-22 |