| NPI | 1871556084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 28597) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 28822) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 39390) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-10-27 |