| NPI | 1275520736 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME42393) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME0042393) | 
| Enumeration Date | 2005-09-30 | 
| Last Update Date | 2023-04-25 |