| NPI | 1265497663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME75762) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME0075762) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME75762) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2015-04-15 |