| NPI | 1053366229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME91763) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME 91763) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-03-04 |