| NPI | 1033197504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME125455) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35065372) |
| 208800000X Urology (Licence: OH 35-065372) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-06-20 |