| NPI | 1912047176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 6310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 6310) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-11-13 |