NPI | 1225323678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME123249) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT200411) |
Enumeration Date | 2011-06-14 |
Last Update Date | 2018-03-07 |