| NPI | 1235212267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME86280) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME86280) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2022-01-19 |