| NPI | 1346214160 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME0059272) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME59272) | 
| Enumeration Date | 2006-02-16 | 
| Last Update Date | 2015-06-10 |