| NPI | 1760489900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS16007) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 1827) |
| 207V00000X Obstetrics & Gynecology (Licence: DE C2-0007699) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2022-07-30 |