| NPI | 1174528087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME87091) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME87091) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2010-07-14 |