| NPI | 1922243617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 31711) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY R1809) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2020-10-01 |