| NPI | 1013985357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME 0063568) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME 0063568) |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2018-08-15 |