| NPI | 1033148614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101030655) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME126011) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-06-14 |