| NPI | 1326035452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME58884) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME0058884) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2023-07-10 |