| NPI | 1265469464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME39272) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME0039272) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2015-08-25 |