| NPI | 1881631562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DE C2-0004116) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS005401L) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-03-23 |