| NPI | 1356548168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ME DO2524) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 670) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2019-03-19 |