| NPI | 1285620062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME65397) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 11605) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME65397) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-08-20 |