| NPI | 1235155854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: FL ME43574) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME43574) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME43574) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-07-18 |