| NPI | 1891776613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 18514) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AR R4646) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-07-08 |