| NPI | 1164412771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME72088) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: GA 033121) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-03-21 |