| NPI | 1164590014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME32853) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL me32853) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2011-11-29 |